Policing and Health Collaboration in England and Wales Landscape review
Policing and health collaboration in England and Wales: Landscape review
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About Public Health England
Public Health England exists to protect and improve the nation’s health and wellbeing,
and reduce health inequalities. We do this through world-leading science, knowledge
and intelligence, advocacy, partnerships and the delivery of specialist public health
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and a distinct delivery organisation with operational autonomy. We provide
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Prepared by: Helen Christmas, Linda Hindle, Michelle McManus, Lauren Metcalfe,
Justin Srivastava.
© Crown copyright 2018
You may re-use this information (excluding logos) free of charge in any format or
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Published February 2018
PHE publications PHE supports the UN
gateway number: 2017765 Sustainable Development Goals
Policing and health collaboration in England and Wales: Landscape review
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Contents
About Public Health England 2
Foreward 5
Executive summary 7
Introduction 7
Methods 7
Findings 7
Collaborative working 7
Conclusions 8
Introduction 9
Context 10
Vulnerability, offending, health and local policing 10
Multi agency working 11
Policy context 11
Benefits and complexities 12
What works? 13
Methods 14
Survey 14
Responses 14
Case studies 14
Analysis 15
Strengths and weaknesses of the landscape review 15
Findings 16
Health and wellbeing boards 16
Completed, active and future collaborative work 16
Good practice examples 18
Organisational priority areas and demand 20
Lessons learned 20
Information sharing 20
Barriers and enablers to collaborative working 21
Leadership 21
Summary of findings 21
Policing and health collaboration in England and Wales: Landscape review
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Collaborative working 22
Early intervention and adverse childhood experiences 22
Mental health problems and vulnerability 26
Substance misuse 29
Evidence, data, value for money and academic collaborations 30
Conclusions 32
List of abbreviations 33
Acknowledgements 33
References 34
Annex 1: Survey respondents 38
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Foreward
© Guzelian
Duncan Selbie, CEO Public Health England
The factors which lead to poor health such as adverse childhood experiences, poverty,
social exclusion and addiction are also the factors which increase the likelihood of
being involved in crime.
Police forces and health organisations serve a common purpose and by working
together we can improve outcomes not only for individuals, but for wider communities.
This landscape review provides a comprehensive picture of the ways in which we are
collaborating as we strive to improve public safety, reduce crime and improve health
outcomes.
Building on the range of case studies in Police and Public Health: Innovations in
Practice: an overview of collaboration across England, the review supports and
underpins the consensus statement, Policing, Health and Social Care: working together
to protect and prevent harm to vulnerable people, which sets out our ambition to go
further and faster by working together in the public interest.
Policing and health collaboration in England and Wales: Landscape review
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Andy Rhodes, Chief Constable Lancashire Constabulary
The dilemma facing decision makers in policing is how best to adapt our response to
new threats whilst staying true to the Peelian principle of “The test of police efficiency
is the absence of crime and disorder, not the visible evidence of police action in dealing
with it”.
Throughout austerity we have seen worrying signs that the investment in prevention is
proving hard to sustain yet the landscape review which underpins the consensus has
identified much innovation with our partners from health. We are seeing practitioners
adapt, moving from collaboration to integration with a shared purpose to take action
early. We estimate 80% of police demand can be described as working with client
groups who have complex needs and we are slowly starting to realise that health
interventions supported by health data hold the key to not only preventing escalation of
need but also crime. There is a clear and unequivocal link between health inequality
and crime.
The consensus is a clear statement of intent about our shared purpose, it is not a
burning platform but a burning desire to build on the innovation we have found, further
develop the evidence about what works and scale up to meet the challenges of the
future.
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Executive summary
Introduction
The links between health, offending and policing are complex but inextricable.
Collaborative working between the police and health has a long history but is still not
commonplace. This landscape review aims to consider the breadth of the subject, and
also to look at emerging themes and to influence future approaches.
Methods
A survey was distributed to all police forces, offices of the police and crime
commissioners and various national and regional organisations. A mixture of
quantitative and qualitative analysis was undertaken, identifying themes and coding
quantitatively for descriptive and visual statistics. A number of respondents were
contacted for more detailed information about the work they had described in their
responses.
Findings
Respondents were asked about areas of past, current and future collaborative work.
Mental health, health in custody and drugs were identified most frequently for past and
current work. Social isolation, homelessness and adverse childhood experiences
(ACEs) scored highest for future work. Examples of collaborative work were given, and
these fell into a number of themes: mental health problems, early intervention,
substance misuse, violence prevention and sexual abuse. These corresponded well to
the organisational priorities and main areas of demand that respondents described.
Notably, the demand was centred on vulnerability rather than traditional types of crime
and disorder, which corresponds to national estimates of demand. There was a mixed
picture of engagement with health and wellbeing boards. Barriers to collaboration and
to information sharing included risk aversion and IT systems. Enablers included shared
goals, relationships and information sharing.
Collaborative working
This section of the report discusses the themes emerging from the landscape review in
more detail and uses case studies. Key areas for future discussion and action include
further developing the approach to ACEs, applying an early intervention lens to more
areas of work, filling gaps in research and spreading good practice and innovation.
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Conclusions
The landscape review provides a snapshot of the breadth and depth of collaborative
working between police and health colleagues in England and Wales. The responses
indicate an increasing police focus on vulnerability and a commitment to prevention
across all partners, which now need to be systematised. Looking ahead, this work will
influence the current debate on the future of local policing; and the benefits of
collaborative working.
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Introduction
This report presents the findings of a landscape review of collaborative work between
police and health in England and Wales.1 A landscape review captures what is going on
in a particular field to inform stakeholders and other interested parties about the subject.
This landscape review was designed to consider the breadth of the police and health
collaboration, but also to look at emerging themes in some depth to influence future
approaches. The landscape review was carried out by a small multiagency group on
behalf of the Policing and Health Consensus national working group. It is designed to
underpin work to develop and implement a national police and public health consensus
by reflecting the system-wide picture of collaborations between policing and health
currently, identifying gaps and contributing to understanding of the system conditions
which support collaborative working especially around early intervention. It is also
designed to assist in the design and delivery of a new local policing model.
The report begins with an overview of the academic literature and policy context for joint
working between police and health before presenting the methodology and findings of
the landscape review. Themed areas of work are then discussed in more detail using
case studies and examples.
1 In this report ‘police’ refers to police forces in England and Wales, and offices of police and crime commissioners. ‘Health’
refers to NHS provider organisations, private and third sector healthcare organisations commissioned by the NHS or local
authorities, NHS England, Public Health England, Public Health Wales, and local authority public health teams.
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Context
This section of the report is informed by a literature review. Papers were identified using
the search terms ‘police’ and ‘health’ and were excluded if they were not published
within the last 10 years. A separate search for policy papers and other grey literature
was undertaken using the snowballing technique.
Vulnerability, offending, health and local policing
The links between health, social inequality and crime are complex. Offenders suffer
significantly worse health than the general population and are also more likely to be
victims of crime (Anders et al, 2017). People in contact with the criminal justice system
often have multiple and complex health and social needs which are interlinked with a
propensity to offend (ibid). By working to address the social exclusion and health-related
problems related to criminal behaviour, crime can be prevented. For example, it is
estimated that around one-third to a half of all acquisitive crime is committed by drug
users (NTA, 2009). Tackling the ‘causes of the causes’ involves looking beyond the
immediate health need to understand why that has arisen in the first place. Approaches
such as adverse childhood experiences (ACEs) highlight the physiological changes and
lifelong negative effects that childhood stress causes and argue for trauma-focused
interventions to improve health and social outcomes, thereby reducing crime (Bellis et
al, 2013). Prevention of ACEs in the first place sits alongside this.
Recent policy papers for both policing and public health continue to highlight the need
for cross-sector partnership working to enable and prioritise upstream intervention. Two
examples are ‘From evidence into action’ (PHE, 2014) and ‘Policing Vision 2025’
(NPCC, 2016). The former sets out 7 key priorities for the public health community to
focus on including ensuring every child has the best start in life, reducing harmful
drinking and reducing dementia risk – all of which have a direct impact on policing.
‘Policing Vision 2025’ looks towards a developing local policing model with proactive
prevention and where the police support multiagency neighbourhood projects. Both
documents highlight the evolving makeup of communities, developing technology and
societal changes. In their 2016 report, Her Majesty’s Inspectorate of Constabulary
identified concerns about the lack of focus on neighbourhood policing. The
recommendations for addressing this centre around prevention, engagement, and
multiagency working (HMIC, 2017). Increasingly, a locality-based approach with whole
place commissioning rather than individual services is being discussed and developed
(NPCC, 2016; GMCA, 2017).
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Multi agency working
Public sector partnership working in the UK is not easy to define (Cook, 2015). It ranges
from strategic level partnership to multiprofessional working. The characteristics of
multiagency working include:
the structure and/or way of working involves 2 or more organisations
these organisations retain their own separate identities
the relationship between the organisations is not that of contractor provider
there is some kind of agreement between the organisations to work together in
pursuit of an agreed aim
this aim could not be achieved, or is unlikely to be achieved by any 1 organisation
working alone
relationships between organisations are formalised and are expressed through
operational structures and the planning, implementation and review of an agreed
programme of work (Cook, 2015)
This is a useful working definition, because it distinguishes partnership working from
other forms of joint service delivery such as integration at 1 end of the spectrum, and
informal day to day co-operation between agencies at the other.
Policy context
While multiagency working has been part of the public sector approach for many years,
the focus on partnership working intensified in the late 1990s and early 2000s with
policy drivers around efficiency and seamless customer experiences (Vangen and
Huxham, 2003).
Statutory requirements for police and health to work together came in the Children’s Act
1989 and the Crime and Disorder Act 1998. The latter established community safety
partnerships in each local authority area in England and Wales with ‘responsible
authorities’ including police, local authorities, fire and rescue services, probation and
health. Section 13 of the Children Act 2004 requires each local authority to establish a
local safeguarding children board for their area and specifies the organisations and
individuals that should be represented. They have a range of statutory roles and
functions, with the purpose of co-ordinating and ensuring the effectiveness of local work
to safeguard and promote the welfare of children. Health and wellbeing boards were
established in England as part of the Health and Social Care Act 2012. They are a
formal committee of the local authority and oversee a joint strategic needs assessment
and joint health and wellbeing strategy for their area. Police forces and police and crime
commissioners are not required to be members, although this is encouraged (Rudd and
Hunt, 2016).
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Further examples of multiagency arrangements incorporating policing and health
include the national mental health crisis care concordat, which has been signed up to by
27 national bodies and commits them to working together better to support people when
they are having a mental health crisis (HM Government / Mind, 2017). More recently,
sustainability and transformation partnerships (STP) have been set up across local
health economies, with the purpose of improving quality and developing new models of
care, improving health and wellbeing and improving efficiency of services (King’s Fund,
2017a). Their impact on policing and health collaboration, prevention and early
intervention is as yet untested.
In 2016 a summit organised by Public Health England (PHE) and Lancashire
Constabulary gave a mandate to develop a policing and public health consensus to
define how the police service and health and social care services will work together to
improve people’s health and wellbeing, reduce crime and protect the most vulnerable
people in England and Wales.
Benefits and complexities
The Home Office (2013) identifies 3 common principles of multiagency working:
information sharing, joint decision-making and co-ordinated intervention. The
motivations behind collaborative working include cost saving, effectiveness and
improved experience for the service user. Vangen and Huxham (2003) propose a
concept of collaborative advantage and collaborative inertia. Collaborative advantage is
where working together achieves something that 1 organisation alone cannot achieve.
Often this is the primary motivation for collaborations. The advantage is derived from
the different perspectives, skills, resources and opportunities the different organisations
bring. However, these very differences can make it much harder to actually achieve
meaningful outcomes: collaborative inertia.
Work to unpick the facilitating and challenging factors for general multiagency working
has resulted in the following list of theme: role demarcation, commitment, trust and
mutual respect, understanding other agencies, communication, clarity of purpose,
planning and communication, organisation, information exchange, funding, staffing and
time (Atkinson et al, 2007). More specifically examining police and health collaborations,
observers highlight the constant risk that partners will ‘fall back’ into their traditional
roles particularly in areas of work where policy goals and approaches are very different,
such as illicit drugs (Collier, 2017).
The complexity and fragmentation of the NHS in England is also frequently cited as a
barrier to partnership working with colleagues both within and outside the health system
struggling to know who to approach (King’s Fund, 2017b; House of Commons Health
Committee, 2016).
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What works?
A rapid review by Berry and colleagues considered the evidence for the effectiveness of
partnership working in a crime and disorder context. It highlighted the mechanisms
found to be associated with effective partnership working, using examples mainly from
the United States. These mechanisms are: leadership, data sharing and problem
solving focus, communication and co-location, structures and experience (Berry et al,
2011). Alongside the need for a shared vision and purpose, these mechanisms are
commonly identified across the literature on policing and health partnership working in
the UK (Vangen and Huxham, 2003; Crawford and L’Hoiry, 2015; de Viggiani, 2013;
Horspool, 2016; Collier, 2017). A forthcoming document from the Centre of Excellence
for Information Sharing demonstrates effective information sharing and the mechanisms
behind it (CEIS, unpublished). The need for nurturing leadership is also a recurring
theme. An international commentator concludes with the view that “holistic models of
community safety and wellbeing are the future”, but that systemic change is necessary
to achieve this (Collier, 2017).
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Methods
Survey
A survey was designed using some closed, but primarily open questions. Sections
included demographics, information about collaborative working, organisational
priorities and governance, workforce development and information sharing. It was
designed so that 1 person could complete it on behalf of their organisation. Two
versions were created, 1 for police forces and offices of the police and crime
commissioners (OPCCs) and 1 for other organisations. The questions were the same,
but wording was altered slightly to reflect the different nature of the respondents (force
vs organisation). The survey was developed and sense-checked by a working group
that included police, public health, and academic colleagues. Surveys were sent to all
police forces and OPCCs in England and Wales and a smaller number of
national/regional bodies such as NHS England, PHE, Public Health Wales (PHW), and
the College of Policing.
Responses
A total of 54 full and partially completed surveys were returned, 40 from police forces
and OPCCs (‘police’ surveys) and 14 from other organisations (‘regional/national’
surveys). The full list of contributors is included in Annex 1. In all, 29 of the 43 police
force areas (67%) in England and Wales were represented. Ranks of responding police
officers ranged from police constable to chief superintendant, and areas of work varied
considerably. Of the respondents from the regional/national group, 6 worked in regional
roles and 8 in national. Seven national and regional organisations were invited to
participate and 5 of them did so (71%), but there was more than 1 response from 2 of
these organisations.
Case studies
Once all the surveys had been returned, a number of the respondents were contacted
for more detail about work they had mentioned, and 2 police forces that had not
submitted survey responses contributed additional examples of collaborative work. The
case studies included have been chosen to reflect key themes in the landscape review,
but are not intended to imply that these projects are necessarily any better than others.
There were many other case studies we would like to have included had we had the
time and space. Case studies around liaison and diversion schemes were not included
as this is part of a national roll out and they are documented elsewhere (NHS England,
2017).
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Analysis
A mixture of quantitative and qualitative analysis was undertaken, identifying themes
and coding quantitatively for descriptive and visual statistics.
Strengths and weaknesses of the landscape review
The decision to survey police forces, but not equivalent NHS mental health, acute and
provider trusts or local authority public health teams and community safety partnerships
was taken for practical reasons (number of contacts to find), but also because we
judged that asking 1 element of the multiagency team would be sufficient and would
avoid duplication. When contacted for further details, a number of the forces referred
the researcher on to partners which indicates that this was successful. Surveying
national and regional health and policing bodies was done to get a different perspective
by including commissioner and policy organisations. However, the 2 groups are not
comparable and the survey was not designed for them to be contrasted.
The survey deliberately did not define concepts like ‘health’, ‘mental health’ and
‘vulnerability’ to avoid limiting people’s responses. Inevitably however, there was some
variation in interpretation of the questions which makes it harder to draw firm
conclusions from some of the analysis.
It is possible that those who have responded represent organisations that are more
committed to collaborative working and so they may not be completely representative of
organisations across the country. However, efforts were made to ensure as large a
response rate as possible, for example extending the deadline for return of the survey,
and sending reminders to organisations that hadn’t originally responded.
Although the questionnaire was designed to be filled in by 1 person on behalf of their
organisation, many respondents were only able to talk about work they were personally
aware of, so there will be gaps.
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Findings
This section of the report presents and discusses the general findings from the survey.
Health and wellbeing boards
Police forces were asked whether they were represented on health and wellbeing
boards. The majority said yes. Fifteen respondents named the health and wellbeing
board(s) that their force is represented on. However, others went on to describe
partnerships which were not statutory health and wellbeing boards, indicating that the
question may not have been specific enough. Structures in Wales are different and
Welsh colleagues sit on public service boards. Membership of health and wellbeing
boards can be a contentious issue as police and OPCCs are not statutory members,
and in some areas of the country they have not been offered a seat.
Completed, active and future collaborative work
Respondents were provided with a list of potential areas for collaborative work between
police and health, and asked to indicate those areas where they had completed
collaborative projects; were involved in active collaborative projects; or considered they
may be involved in collaborative work in the future.
Overall, the most popular areas for collaborative work were mental health, health in
custody and drugs (Table 1). The same 3 areas came top in completed and active work;
however, social isolation, homelessness and ACEs were the top 3 for possible future
collaborations. This shift potentially indicates a move towards earlier intervention and
prevention from a policing perspective.
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Table 1: Areas of collaborative work, in order of total number of mentions
Area of work Completed
work Active
work
Possible future work Total
Mental health 17 43 12 72
Health in custody 18 37 10 65
Drugs 16 38 8 62
Alcohol 15 34 9 58
Prevention of offending and reoffending 13 32 12 57
Child sexual exploitation 13 30 11 54
Suicide prevention 10 33 8 51
Safeguarding 11 31 8 50
Domestic abuse 10 31 8 49
Dementia 9 24 12 45
Violence prevention 7 24 13 44
Sexual health 7 19 13 39
Missing from home 7 22 10 39
ACE (adverse child experiences) 3 17 17 37
Homelessness 2 16 19 37
Sex workers 8 17 12 37
Modern slavery 6 21 10 37
Neglect 5 20 12 37
Radicalisation 8 15 10 33
Social isolation 1 8 20 29
Long term conditions 2 7 15 24
Physical activity 1 6 16 23
Obesity 1 5 15 21
Migrant health 1 4 16 21
Overall, the most popular areas for collaborative work were mental health, health in
custody and drugs. The same 3 areas came top in completed and active work; however,
social isolation, homelessness and ACEs were the top 3 for possible future
collaborations. This shift potentially indicates a move towards earlier intervention and
prevention from a policing perspective.
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Good practice examples
Participants were asked to give brief details of a collaborative policing and health project
that they felt represented good practice. Thirty-eight examples were given. Most
respondents also listed a number of other projects they had been involved in. Project
areas are listed below. Many were mentioned more than once.
Mental health problems: Early intervention:
street triage ACE
mental health first aid multiagency early intervention pilot
high intensity user care packages Early Intervention Foundation partnership
suicide prevention
enhanced training Others:
OPCC criminal justice & mental health forum concern for welfare
dementia projects
Substance abuse: building community capacity and resilience
liaison and diversion custody healthcare
support for street drinkers LGBT victim support
say no to drunks vulnerable victims support
drug and alcohol referral schemes proactive vulnerability engagement team
information sharing and data focus
Sexual abuse: modern slavery
Sexual Assault Referral Centre (SARC) research collaborations
child sexual exploitation (CSE) trauma-informed risk management
CSE prevention missing persons
engagement and safeguarding of sex
workers
Violence prevention:
multiagency tasking and co-ordination
(MATAC)
violence prevention alliance and network
women’s support workers
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The lead agencies for the headline projects varied considerably (Table 2).
Table 2: Lead agency in ‘good practice projects’
Lead agency Number of projects
Police 14 Public health / health 9 Home office 1 OPCC 1 Community safety team 1 Health and police joint lead 7 Name of the multiagency partnership given 2 Police and other 3
Overall, the number of police and non-police leads seems fairly balanced in number,
which does not support the suggestion that police tend to volunteer or be relied upon to
lead because of their command and control culture. It is not clear whether this is
reflective of wider practice. The way these responses were written implied some ‘leads’
were simply the commissioners and many respondents put down more than 1 agency.
This might indicate that no single agency is leading intentionally, that the people driving
the project and leading day to day are from different organisations, or simply that the
person responding on behalf of their organisation was not familiar with the detail.
However, it may indicate a lack of clarity about leadership within some projects which is
potentially concerning given the importance of leadership to the success of collaborative
working.
A long list of partners involved in the good practice projects was compiled from the
responses. These include universities, licensed trade, third sector and several national
government bodies. This is a reminder that the common problems health and police are
working together to address are also within the remit of many other organisations from
different sectors and at different scales.
Funding for the majority of projects came from more than 1 partner, with 19 of 32
projects where funding information was provided being jointly funded. A further 6 were
health funded: 3 Home Office, 3 OPCC and 1 police. Four were cost-neutral or had no
additional funding provided.
Measuring impact was generally done via collaboration with academic bodies, through
evaluations and/or by using outcomes frameworks. Evaluation was mentioned more
frequently by the regional/national group, and academic collaboration more by the
police group, although this may have been a terminology issue as there were a number
of examples of academic organisations undertaking project evaluations. Academic
collaboration was a particular feature of the more in depth case study discussions, with
several participants able to share external reports.
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Organisational priority areas and demand
Respondents were asked to identify the priorities of their organisations that related to
policing and health.
Six key areas emerged:
mental health problems
vulnerability
sexual crimes
violent and abusive crimes
substance misuse
offender healthcare
Mental health was listed by more than half of respondents. Although no definitions were
contained in the survey, it is likely that it refers to mental health problems, and
encompasses both diagnosable mental disorders and mental health problems that do
not meet diagnostic criteria. Further discussion about this can be found on page 23.
Police participants were also asked to describe the areas of greatest demand (either
volume or severity) and/or concern for their organisation. The question did not specify
that these were to do with collaborative working, but even so the most common
responses were mental health, vulnerable people, violent and abusive crimes,
substance misuse and child sexual exploitation, all of which link to vulnerability. These
match well against the force and organisation priorities. Again, mental health was listed
by almost every respondent.
Lessons learned
Two key themes came out of the responses around lessons learned from collaborative
projects: positive practice and infrastructure. Leadership was mentioned often in a
positive light. IT systems were also frequently raised, often as a barrier.
Information sharing
When describing good practice projects, most respondents referred to information
sharing agreements or protocols. A ‘common sense’ approach was also mentioned.
They were asked to describe enablers and blockers. Themes were:
Enablers Blockers
information sharing protocols risk aversion and lack of understanding
IT systems lack of national ownership
joint vision IT systems
good relationships
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In addition to these themes, the complexity of the health service architecture and
resources were both highlighted.
Barriers and enablers to collaborative working
These were similar to information sharing enablers and blockers, with shared goals
being a key theme. Respondents also mentioned legislative frameworks as both
enablers and blockers, with the Welsh Future Generations Act seen as a positive lever.
The complexity of the NHS structures was highlighted as a challenge.
Leadership
Participants were asked about organisational leadership, recruitment and staff
development initiatives to support collaborative working. Few responded, perhaps
indicating this was not part of their remit. Examples included joint training and co-funded
posts. However, strong leadership was mentioned often in questions about enablers to
partnership working.
Summary of findings
Overall, the landscape review found a wide range of work with a wide range of partners,
which reflects the priorities and concerns identified by respondents. Areas of work such
as street triage and liaison and diversion were mentioned the most frequently, and
seem to have acted as a ‘gateway’, allowing forces and health organisations to see the
benefits of working together. Fewer examples of good practice around substance
misuse were shared than expected given that it was rated highly on the list of
completed, active and future work. This might indicate that the work is well established
and didn’t come to mind when we asked for good practice examples, or might suggest
that this is an area that could benefit from some revitalising.
Overall, most of the examples given were of reactive or crisis-led work. Innovative
prevention-focused work such as that around early intervention and ACEs is emerging
and was discussed with great enthusiasm by interviewees. It is anticipated as a future
collaborative development in many force areas, which would suggest a much more
upstream approach is likely to be much more prevalent in the coming years.
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Collaborative working
This section of the report looks in more detail at some of the key themes that have
emerged from the landscape review. Each theme contains some background
information and some examples of projects that were shared as part of the landscape
review. Some key questions for discussion are posed. These have emerged from the
literature review, survey responses and particularly the interviews with participants.
They are designed to provoke discussion and do not necessarily reflect the authors’ or
survey respondents’ views.
Early intervention and adverse childhood experiences
Early intervention
An increasing focus for collaboration between police and health is in early intervention.
Definitions vary, but include intervening as early as possible to tackle emerging
problems, usually (but not always) with children and families (Early Intervention
Foundation, 2017; National Audit Office, 2013; C4EO, 2014; Early Action Task Force,
2001; Allen, 2011). The National Audit Office (2013) identifies 3 types of early action:
prevention (upstream): preventing or minimising the risk of problems arising, usually
through universal policies like health promotion
early intervention (midstream): targeting individuals or groups at high risk or showing
early signs of a particular problem to try to stop it occurring
early remedial treatment (downstream): intervening once there is a problem to stop it
getting worse and redress the situation
The National Audit Office notes that high quality evidence about impact and cost
effectiveness of early action is limited but concludes that shifting resources into early
action would be beneficial. The Early Intervention Foundation summarises the existing
evidence for early intervention from economics, sociology, psychology, and
neuroscience. They argue that wide gaps in children’s wellbeing that have significant
long term consequences develop early in life; but can be influenced by timely
interventions (EIF, 2014). These arguments are also developed in ‘Fair Society, Healthy
Lives’ (Marmot, 2010) which proposes 6 policy objectives to tackle the social gradient in
health, all of which are linked to early action:
give every child the best start in life
enable all children young people and adults to maximise their capabilities and have
control over their lives
create fair employment and good work for all
Policing and health collaboration in England and Wales: Landscape review
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ensure healthy standard of living for all
create and develop healthy and sustainable places and communities
strengthen the role and impact of ill health prevention
A particular area of focus is adverse childhood experiences (ACEs). An initial study in
the US (Felitti et al, 1998) was followed by studies in the UK (Bellis et al 2013, 2014,
2015). These showed that stressful experiences during childhood such as physical,
sexual or emotional childhood abuse, family breakdown, exposure to domestic violence,
or living in a household affected by substance misuse, mental illness or where someone
is incarcerated are linked to poor health and social outcomes in adults. Independent of
the relationship with deprivation, the more ACEs a person has experienced, the higher
their risk of adverse behavioural, mental and physical outcomes throughout their life
(Bellis et al, 2013). The Welsh ACEs study found that those with 4 or more ACEs were
15 times more likely to have committed violence in the last month, 16 times more likely
to have used crack cocaine or heroin and 20 times more likely to have been
incarcerated in their lifetime than those with no ACEs (Bellis et al, 2015). This impacts
on public health and policing on many levels, from how we deal with offenders, right
through to the imperative to prevent ACEs in the first place.
Examples of early intervention collaborations are given below.
Breaking the generational cycle of crime: South Wales
Funded by the Home Office police innovation fund, this 2-year programme of work is the
first of its kind where an ACE informed public health approach is applied with the police
to address vulnerability and risk through early action. This is a collaboration between
Public Health Wales, the Police and Crime Commissioner for South Wales, South
Wales Police, NSPCC, Barnardo's and Bridgend County Borough Council. The
programme aims to provide the police and other partners with the right knowledge, skills
and support to identify children and families who are at risk of being affected by ACEs
and respond to them in an appropriate and effective way at the earliest opportunity.
Creating a trauma-informed work force is a key step in reducing harm and preventing
the transmission of ACEs to the next generation. Longer term, this approach could lead
to resilient individuals and safer, stronger communities. We have an opportunity to
connect people with appropriate and available services to provide them with a number
of the building blocks required to protect themselves against the negative impact of
trauma.
Five recommendations have been developed based on findings from extensive
research undertaken by Public Health Wales and are being taken forward by South
Wales police.
Policing and health collaboration in England and Wales: Landscape review
24
The recommendations are:
pilot a structured multiagency, early intervention approach to vulnerability with
Neighbourhood Policing Team (NPTs)
pilot a training programme with ‘fast’ and ‘slow time’ policing on ‘ACE informed
approach to policing vulnerability’
work with the public protection department to develop an ACE informed approach
to the existing public protection notice (PPN) process
to develop with partners a 24/7 ACE informed approach to responding to
vulnerability
work with human resources to assist with the development of the wellbeing agenda
within South Wales police, specifically focusing on how staff are mentored and
supported to deal with vulnerability
Complementing the work with South Wales police, the programme also includes work with
housing and education within the pilot area to ensure a whole system, place based
approach to addressing vulnerability demand through an ACE lens. In addition, there is
extensive engagement with many of the other services and agencies within the pilot area
who also support vulnerable people to ensure they are aware of the ongoing work and can
play their part in offering appropriate and effective help at the earliest opportunity.
Transforming Lives: Blackburn with Darwen and East Lancashire
This is a multiagency integrated ‘place based’ approach to dealing with vulnerability and
risk in Blackburn with Darwen and East Lancashire. In the past, the majority of referrals
to the multiagency safeguarding hub did not result in action, as thresholds for
intervention were not met. This resulted in a cycle of repeat referrals, and effectively
waiting for problems to escalate before intervening. Now, a multiagency panel assesses
all referrals proactively based on the needs of the family or individual, the best action to
take, and which professional should lead. Co-located multiagency teams then provide
the required support with the aim of intervening early to prevent escalation. Partners are
Blackburn with Darwen Borough Council, Lancashire Constabulary, Lancashire Fire and
Rescue Service, Lancashire Care Foundation Trust, East Lancashire Hospitals Trust,
Lancashire and Cumbria Community Rehabilitation Company, families health and
wellbeing consortia – third sector consortia, and registered social landlords.
Key principles of the programme are:
early action and prevention
shared approach
holistic and fully person-centred
concurrent upstream interventions
better and sustainable outcomes
Policing and health collaboration in England and Wales: Landscape review
25
Evaluation by the Centre for Local Economic Strategies (unpublished) estimated that in
the first year, the value of outcomes for each £1 spent was in the region of £6.93. They
described an effective and systematic approach that was well regarded by clients and
key workers and provides strong added value.
The Early Intervention Partnership Hub, Northamptonshire
This developing collaboration has a home-school-street model and provides support
and early intervention for children who don’t necessarily meet the criteria for social care
involvement but are coming to the attention of agencies.
Figure 1: Northamptonshire early intervention hub model (source: Northamptonshire Police)
An early help mechanism had been available for some time locally, but data work
revealed that often the agencies that had referred the child ended up being re-
contacted, and in 70-80% of cases no actual action was taken. However, there were
lots of re-referrals and escalation, indicating a gap in services.
A pilot locality hub is located in the area of highest demand. The initial focus has been
with primary schools because of the prevalence of domestic abuse notifications issued,
because it enables earlier intervention, and because of their nurturing approach.
Secondary schools are also involved in the pilot.
Northamptonshire Healthcare Foundation NHS Trust is involved, as are the police,
school inclusion team, adult and children’s social care, youth offending, the local
Policing and health collaboration in England and Wales: Landscape review
26
domestic abuse charity and drug and alcohol services. The overall expectation is that
existing commissioned services will be used more effectively within the hub model, and
a Big Lottery bid to further develop the project is planned for later 2017.
Challenges have been the shifting public sector landscape and the development of
information sharing agreements (now signed), but partners are keen and committed.
Suggestions for system wide discussion, intervention or investigation
Preventing ACEs occurring, intervening early in childhood when ACEs are beginning to
happen, and intervention with adults who suffered adverse experiences in their own
childhood are very different areas of work. Not all projects seem to distinguish between
them. Is more work needed to pinpoint where the focus is now and where should it be?
The evidence for interventions appears to be limited. There is an opportunity to develop
the evidence base including return on investment analysis.
How do we sustain support in the longer term for people with complex needs?
There is a debate around whether it’s appropriate to screen for ACEs in circumstances
when interventions aren’t readily available: how do we ensure an ethical, solution-
focussed approach?
What are the gaps in provision and how do we fill them?
How do we shift the balance from crisis-led towards preventative?
Mental health problems and vulnerability
Mental health was raised consistently through the landscape review as a primary area
both of concern and of collaboration. Use of terminology can differ between police and
health colleagues, so it is important to be clear about definitions. The Mental Health
Foundation defines mental health as “more than an absence of symptoms of distress, it
includes a positive experience of self, individual resources included self-esteem and
optimism, the ability to sustain relationships and resilience” (Regan, 2016). Mental
health problems “is an overarching term which covers the range of negative mental
health states including, mental disorder – those mental health problems meeting the
criteria for psychiatric diagnosis, and mental health problems which fall short of a
diagnostic criteria threshold” (ibid). Despite using the phrase ‘mental health’ in free text,
it appears most respondents are referring to mental health problems, and/or a lack of
mental wellbeing.
Policing and health collaboration in England and Wales: Landscape review
27
Estimates suggest that 2-40% of police officers’ time is spent dealing with incidents
involving people with mental health problems. (Quinn et al, 2016; College of Policing,
2015). Eighty-four per cent of command and control calls are non-crime related (College
of Policing, 2015). Models of policing are designed to tackle crime, yet the majority of
demand is about vulnerability. This impacts on local policing, as although the police may
not always be the best professionals to deal with the situation, they are the ones who
are called.
An approach to enabling the police to deal more effectively to people in mental health
crisis mentioned by almost all respondents is street triage. Models vary, but mental
health professionals work alongside police officers in cars and/or in the control room to
provide advice and information to enable an appropriate response. In 2012/13 it was
recognised that a small number of forces including Cleveland, Leicestershire and
Hampshire had developed collaborations with mental health colleagues that were
reducing the number of Section 136 detentions2 and decreased the amount of time
officers spent dealing with people who had mental health problems but were not
committing or the victim of crimes.
Other forces were expressing an interest, so a national pilot in 9 forces was set up with
funding from the Department of Health. Each area developed its own model. By the end
of the pilot there were around 24 street triage schemes, and now almost all police forces
have a form of street triage, with the remainder using agreements with local mental
health trusts instead. Street triage service examples are outlined below.
Street triage service: Leicestershire
Leicestershire constabulary was an early adopter of street triage model. Concerns
about the high level of S136 detentions and poor relationships between mental health
and police staff led to a conversation about how to better manage risk, improve
relationships and intervene further upstream. By the end of 2012 a triage car model was
implemented, with reducing reliance on Accident and Emergency (A&E) and S136
detentions. The model has been developed further over time, and there is now a street
triage service that is operational 10am-2am 7 days a week. A mental health nurse and a
police officer work together to provide telephone and face to face advice covering the
whole of Rutland and Leicestershire. The same nurses also staff the liaison and
diversion service and have close relationships with the crisis team in the Emergency
Department at Leicester Royal Infirmary.
Since 2012, the number of S136 detentions has fallen by 89% and is the second lowest
nationally. The street triage service has improved both effectiveness and efficiency in
2 Section 136 of the Mental Health Act 1983 gives police the power to remove a person to a place of safety, or detain them in a
place of safety if they believe them to be mentally disordered and in need of care or control.
Policing and health collaboration in England and Wales: Landscape review
28
responding to mental health crisis situations, with an estimated 500 hours a week of
police officer time saved. Access to patient information and good working relationships
are the key.
Street Triage Pilot Service: Devon
Devon was also 1 of the 9 national street triage pilots funded by the Department of
Health in 2014. As a large rural area, the decision was taken in Devon to develop a
control room model of street triage rather than taking a car-based approach. Devon
Partnership NHS Trust is the provider of the service. It consists of 2 elements: an out of
hours service where a vetted mental health professional is based within the police
control room, but can be deployed to the scene where practical; and an office hours
phone service currently provided by Exeter and Central Approved Mental Health
Professional (AMHP) Service. An evaluation of the service calculates that in 2016/17
277 S136s were averted by the street triage service.
Both funding and support for the project have been shared equally between the CCG
and the OPCC, which has been an important factor in its development. Supportive leads
within the control room have also been key to successfully embedding the
arrangements. Funding has been on a 1-year fixed term basis which made traditional
approaches to recruitment untenable, so a bank of specially trained and vetted staff with
substantive posts elsewhere has been developed. An advantage of this has been that
the staff brings a wide range of specialist backgrounds. They bring this experience into
the control room, but are also able to take back their knowledge of the service to their
substantive roles.
The street triage professionals have access to the police command and control system,
so they are notified very early on of calls. This means they are able to ask for calls to be
passed over to them if they recognise the caller, and can prevent police being deployed.
IT systems are also a challenge, with different NHS trusts in the area using different
systems which the service has had to negotiate access to separately. There is a
balance to be struck between the number of different systems available and the need to
be able to respond quickly. The police have developed 1 information sharing
agreement, and there is an audit trail of each decision on both sides which evidences
the judgements made.
The service continues to develop, with discussions ongoing about covering the whole of
the Devon and Cornwall Police area in the future.
Policing and health collaboration in England and Wales: Landscape review
29
Suggestions for system wide discussion, intervention or investigation
Views about the appropriateness of police involvement in mental health concerns range
from it being inappropriate and not part of the police role; through it being necessary to
reduce demand; to it being a core part of the police’s role in preventing crime and
supporting vulnerable members of society. More work is required to spread
communications about the modern policing role in mental health and how involvement
in early identification and prevention impacts on policing demand.
Good practice and innovation from street triage provides an excellent example of how
collaborations can work in practice and could be used to support wider learning to
enable services to develop and improve.
Substance misuse
Substance misuse, including drug and alcohol misuse, ranked highly among the
collaborative projects highlighted by respondents in the surveys. It overlaps with the
theme of mental health due to dual diagnosis,3 and with an ACE/trauma-informed
approach looking at the underlying influences of substance misuse.
Almost two-thirds of sentenced male offenders and two-fifths of sentenced female
offenders report hazardous drinking prior to going to prison, with about half of these
having severe alcohol dependency (Prison Reform Trust, 2004). Around a quarter of
male and a fifth of female sentenced offenders with an alcohol problem also have a
drug dependency (ibid). On average, 55% of prisoners are believed to be problem drug
users (NTA 2009). Increasingly, new psychoactive substances (NPSs) (also known as
‘legal highs’ even though they have not been legal since May 2016) are causing
concern, but research on their short and long term effects is limited.
REST Centre: Liverpool
The Rehabilitation, Education, Support & Treatment (REST) Centre was developed to
provide support and pathways for holistic support for street drinkers and also aimed to
diffuse the anti-social behaviour associated with street drinking in the city centre. It was
piloted over the summer in 2015, and ran again for 4 months from June to September in
2016 and 2017. The REST Centre is a safe, indoor space where clients may still drink,
but are provided with opportunities for activities and supported to access relevant
services such as registering with a GP, finding and retaining accommodation and
alcohol treatment.
3 Dual diagnosis refers to a person who has a diagnosed mental health disorder and also misuses drugs or alcohol.
Policing and health collaboration in England and Wales: Landscape review
30
The project has been evaluated. Economic analysis suggests that the REST Centre is
cost effective, mainly based on the quality of life gains for individuals using the centre.
The total societal benefit:cost ratio was estimated as £4.80 for every £1 spent. Data on
clients’ wellbeing showed improved scores between the first and second time they were
asked to complete a short validated wellbeing survey. Specific changes in drinking
behaviour were difficult to identify, but there was a reduction in street drinking whilst the
centre was open.
The project was commissioned by the Citysafe partnership, Liverpool’s community
safety partnership. Agencies involved included GPs, the homeless mental health team,
the police, street drinking/rough sleepers outreach team, drug and alcohol services and
housing services.
Suggestions for system wide discussion, intervention or investigation
Can an early intervention and prevention lens be applied to substance misuse?
How might this impact on collaborative working?
Evidence, data, value for money and academic collaborations
Although this isn’t a people-centred or ‘what’ theme like the others, the landscape
review provided many examples of use of data to better target services, use of
evaluation and academic collaboration. It was often raised enthusiastically by
respondents and interviewees as an essential underpinning tool to the quality and
effectiveness of their collaborations. It seems reasonable, therefore to have a ‘how’
theme as well.
Use of data: Northamptonshire
Northamptonshire is undertaking a comprehensive data approach to understanding past
trauma in young people, using very detailed ‘asset reports’ from first-time young
offenders to identify ACEs and to layer with school exclusion, social care and other
data. This is live data that can be used to tailor support for the young person, develop
an understanding of the circumstances of young offenders and also to provide internal
challenge about the relevance and appropriateness of services. For example, the data
focus has shown that bereavement is the main driver in 40% of youth offending service
court cases in the area.
Connect - evidence based policing: North Yorkshire
The Connect project aims to build on partnerships already being developed in North
Yorkshire to find better ways of dealing with mental health issues through increased
Policing and health collaboration in England and Wales: Landscape review
31
collaboration, the identification of ‘what works’, the production and sharing of research
information and improved and more systematic training (Connect, 2017).
Connect is a partnership between the University of York, the College of Policing, North
Yorkshire Police and Tees, Esk and Wear Valleys NHS Trust, York Teaching Hospital
NHS Foundation Trust, North Yorkshire and York Forum, the Higher Education Funding
Council for England, North Yorkshire County Council, Selby District Council, City of
York Council, North Yorkshire Fire and Rescue Services, British Transport Police and
Yorkshire Ambulance Service.
Workstreams include:
systematically reviewing evidence of what works.
developing a better understanding of interagency working
developing and evaluating training of staff in mental health issues and research
methods
sharing learning nationally through the College of Policing and other agencies
The impact of the overall programme of work will be evaluated.
Suggestions for system wide discussion, intervention or investigation
There is sometimes a lack of service user voice in service evaluations and research
generally – what are the barriers and how do we get round them to ensure a more
holistic view of services is heard?
How do we systematise good practice and enable best use of the data and
opportunities we have?
The evidence base for many of the developing areas of preventative and early
intervention work appears to be lagging behind: how do we attract and make the most
of opportunities for evaluation and research?
Policing and health collaboration in England and Wales: Landscape review
32
Conclusions
The landscape review has provided a snapshot of the breadth and focus of collaborative
health and policing work across England and Wales. It indicates a shift in focus from
crime and disorder to prevention, vulnerability and early intervention. The focus in this
report has been on key themes which emerged of early intervention, mental health and
substance misuse. However, there are lots of examples of good practice in areas like
violence prevention, dementia, and addressing vulnerability that we would have liked to
include given unlimited space.
The positivity, commitment and enthusiasm of those involved in the landscape review
was palpable and bodes well for the future. Barriers to collaboration were not mentioned
often, but are real and need to be considered. They include competition for reducing
budgets, the difficulty of demonstrating the impact of prevention, enduring cultural and
organisational differences, incompatible IT systems, and siloed approaches. The
examples in this landscape review show how these can be overcome.
Looking forward, it is anticipated that this work can influence the redesign of
neighbourhood policing and provide a resource for partners. The challenge is to
systematise collaboration, prevention and early intervention so that working together in
the best interests of vulnerable individuals and their communities becomes part of
everyday practice for both police and health colleagues.
The landscape review has provided a snapshot of the breadth and depth of
collaborative working between police and health colleagues in England and Wales. The
responses indicated an increasing police focus on vulnerability and a commitment to
prevention across all partners, which now need to be systematised. Looking ahead, this
work will influence the current debate on the future of local policing and the benefits of
collaborative working.
Policing and health collaboration in England and Wales: Landscape review
33
List of abbreviations
A&E Accident and Emergency
ACE(s) Adverse childhood experiences
CSE Child sexual exploitation
EI Early intervention
L&D Liaison and diversion
MATAC Multiagency tasking and co-ordination
NPTs Neighbourhood policing teams
OPCC Office of the Police and Crime Commissioner
PHE Public Health England
PHW Public Health Wales
PPN Public protection notice
SARC Sexual assault referral centre
Acknowledgements
We are very grateful to those who took the time to complete the survey, and to talk in
more detail about their work. Members of the Police and Health Consensus working
group also advised on the landscape review’s development and on the report. In
particular we would like to thank the following people:
Kim Billingham, Northamptonshire Police
Jo Campbell-Brown, Public Health England
Alex Crisp, Leicestershire Police
Mark Evans, Northamptonshire Police
Jenny Ewels, Liverpool City Council
Daniel Flecknoe, Nottinghamshire County Council
Eleanor Houlston, Public Health England
Jane Leaman, Public Health England
Lauren Metcalfe, University of Central Lancashire
Janine Roderick, Public Health Wales
Bill Scott, North Yorkshire Police
Iola Shaw, NHS England
Vince Treece, NHS England
Ivan Trethewey, NHS England
Steve Twigg, National Police Chief’s Council
Duncan Vernon, Public Health England
Karla Wilson-Palmer, Devon Partnership NHS Trust
Policing and health collaboration in England and Wales: Landscape review
34
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Policing and health collaboration in England and Wales: Landscape review
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Annex 1: Survey respondents
The following organisations responded to the survey.
Bedfordshire Police West Mercia & Warwickshire Police
Devon and Cornwall Police West Midlands Police
Dyfed-Powys Police West Yorkshire Police
Essex Police Cambridgeshire Office of the Police and Crime
Commissioner
Gloucestershire Constabulary Humberside Office of the Police and Crime
Commissioner
Greater Manchester Police North Yorkshire Office of the Police and Crime
Commissioner
Gwent Police Dorset Office of the Police and Crime
Commissioner
Hampshire Constabulary Warwickshire Office of the Police and Crime
Commissioner
Humberside Police West Yorkshire Office of the Police and Crime
Commissioner
Kent Police Association of Directors of Public Health
Leicestershire Police College of Policing
Lincolnshire Police Public Health England
Merseyside Police Public Health England – Alcohol, Drugs and
Tobacco division
Norfolk Constabulary Public Health England – Health and Wellbeing
North Wales Police Public Health England – Public Health, Health
and Justice
North Yorkshire Police Public Health England South West
Northamptonshire Police Public Health England West Midlands
Northumbria Police Public Health England Yorkshire and the
Humber
South Yorkshire Police NHS England – Children and Young Persons
Mental Health Team
Staffordshire Police NHS England – Health and Justice
Suffolk Constabulary NHS England – Older People’s Team
Surrey Police National Police Chief’s Council - Missing
Person Portfolio
Sussex Police UK Faculty of Public Health
In addition, case study information was contributed by Lancashire Constabulary and
Public Health Wales.
Policing and health collaboration in England and Wales: Landscape review
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Annex 2: Survey questions and responses
The survey questions and statistical data on response rates are set out below, although
the free-text responses are not reproduced. There are 2 versions of the survey. The first
was sent to national and regional organisations, while the second was sent to police
forces and offices of police and crime commissioners (OPCCs).
Thirteen completed questionnaires were submitted from regional and national
organisations. An additional 15 partial responses were obtained. Of these, 10 were
removed from the sample due to having no data entered and 4 were removed as only
the agency and role were entered, but no other questions answered. This left 1
response where part of the questionnaire had been answered. Therefore, the total
number of regional/national responses included in the analysis was 14.
Thirty-two completed questionnaires were submitted by police forces and OPCCs. In
addition, 99 were partially completed. Of these, 57 were removed from the sample due
to having no data entered at all; 34 were removed as only the police force and contact
details were entered, with no other questions answered. This left 8 responses where
part of the questionnaire had been answered. Therefore, the total number of
police/OPCC responses included in the analysis was 40.
Policing and health collaboration in England and Wales: Landscape review
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Identifying best practice between Health and Policing collaborative working
Information Sheet Demographic information
1. Organisation / Agency completing the questionnaire?
Response
Percent Response
Total
1 Open-Ended Question 100.00% 14
answered 14
2. What is your role?
Response
Percent Response
Total
1 Open-Ended Question 100.00% 14
answered 14
3. Please provide your contact details:
Response
Percent Response
Total
1 Name 100.00% 14
2 Phone number 100.00% 14
3 Email 100.00% 14
answered 14
Health and Policing collaborative working
4. Using the list below, please could you indicate the areas where your organisation / agency has been involved with, or influenced partnership work between health and policing. Please complete this regarding any completed, active or possible future work. Please select any that apply.
Completed
work Active work
Possible future work
Response Total
Safeguarding 1 7 3 11
Alcohol 4 12 3 19
Drugs 4 12 3 19
Violence prevention 1 8 3 12
Health in custody 4 12 2 18
Prevention of offending and reoffending 3 9 2 14
Mental Health 4 11 3 18
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4. Using the list below, please could you indicate the areas where your organisation / agency has been involved with, or influenced partnership work between health and policing. Please complete this regarding any completed, active or possible future work. Please select any that apply.
Completed
work Active work
Possible future work
Response Total
ACE (Adverse Child Experiences) 1 7 4 12
Domestic Abuse 1 5 2 8
Social Isolation 0 2 3 5
Homelessness 0 3 4 7
Obesity 0 1 4 5
Physical Activity 0 3 5 8
Sexual Health 0 3 4 7
Child Sexual Exploitation 2 3 4 9
Suicide prevention 2 10 3 15
Migrant Health 0 2 3 5
Sex workers 1 2 2 5
Radicalisation 1 3 3 7
Long term conditions 0 2 3 5
Dementia 0 4 3 7
Modern Slavery 0 1 4 5
Missing from home 0 1 4 5
Neglect 0 2 4 6
answered 14
5. Please give details of any pieces of work that your organisation / agency is / has been involved with that have cut across both health and policing (regardless of whether an official collaborative partner was involved)
Title:
Brief (to include aim of project
and key agencies involved):
Response Total
Work 1:
Work 2: etc…
answered 13
6. From the list of pieces of work noted in Q5 above, please select ONE project that you feel best highlights good practice relevant to health and policing, and answer the following questions: (State NA if not applicable):
Response
Percent Response
Total
1 Lead Agency: 100.00% 12
2 Other Agencies/Partners involved: 100.00% 12
3 Main aim: 100.00% 12
Policing and health collaboration in England and Wales: Landscape review
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6. From the list of pieces of work noted in Q5 above, please select ONE project that you feel best highlights good practice relevant to health and policing, and answer the following questions: (State NA if not applicable):
Response
Percent Response
Total
4 Duration (or expected duration): 91.67% 11
5 How was the work funded: 100.00% 12
6 Was this a local / regional / national project? 100.00% 12
7 How did you manage data/information sharing? 100.00% 12
8 How did you measure impact / what outcome framework was used? 91.67% 11
9 Any key lessons to be taken from this work? 83.33% 10
answered 12
Organisational Priorities
7. What are the key priority areas for your organisation / agency currently that are relevant to health and policing? (please list what these priorities are, and include link if relevant)
Response
Percent Response
Total
1 Open-Ended Question 100.00% 14
answered 14
8. Thinking about the list in Question 4 (or any other areas that are relevant), which aspects of health and policing are responsible for the greatest demand (volume and/or severity), or concern for your organisation / agency currently?
Response
Percent Response
Total
1 Open-Ended Question 100.00% 13
answered 13
Governance, workforce development and information sharing
9. Please could you give details of any workforce development initiatives that your organisation / agency is involved with, which may impact on collaborative working across health and policing:
Response
Percent Response
Total
1 Leadership: 75.00% 9
2 Developing employee skill sets: 83.33% 10
3 Recruitment: 25.00% 3
answered 12
Policing and health collaboration in England and Wales: Landscape review
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10. Regarding information sharing between health and policing, what have been / what do you foresee as:
Response
Percent Response
Total
1 Enablers: 85.71% 12
2 Blockers: 92.86% 13
answered 14
11. What do you foresee as general enablers and blockers for collaborative working between health and policing?
Response
Percent Response
Total
1 Enablers: 100.00% 13
2 Blockers: 84.62% 11
answered 13
12. Do you have any further comments regarding best practice / gaps / future visions to help inform future collaborative working between health and policing?
Response
Percent Response
Total
1 Open-Ended Question 100.00% 6
answered 6
Policing and health collaboration in England and Wales: Landscape review
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Identifying best practice between Policing and Health collaborative working
Information Sheet Demographic information
1. Police Force completing the questionnaire?
Response
Percent Response
Total
1 Open-Ended Question 100.00% 40
answered 40
2. What is your role/rank?
Response
Percent Response
Total
1 Open-Ended Question 100.00% 40
answered 40
3. Please provide your contact details:
Response
Percent Response
Total
1 Name 100.00% 40
2 Phone number 100.00% 40
3 Email 100.00% 40
answered 40
Policing and Health collaborative working
4. Using the list below, please could you indicate the areas where partnership work between your Force and health has been undertaken (completed), currently undertaken (active) and will be undertaken (possible future work).Please select any that apply.
Completed
work Active work
Possible future work
Response Total
Safeguarding 10 24 5 39
Alcohol 11 22 6 39
Drugs 12 26 5 43
Violence prevention 6 16 10 32
Health in custody 14 25 8 47
Prevention of offending and reoffending 10 23 10 43
Mental Health 13 32 9 54
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4. Using the list below, please could you indicate the areas where partnership work between your Force and health has been undertaken (completed), currently undertaken (active) and will be undertaken (possible future work).Please select any that apply.
Completed
work Active work
Possible future work
Response Total
ACE (Adverse Child Experiences) 2 10 13 25
Domestic Abuse 9 26 6 41
Social Isolation 1 6 17 24
Homelessness 2 13 15 30
Obesity 1 4 11 16
Physical Activity 1 3 11 15
Sexual Health 7 16 9 32
Child Sexual Exploitation 11 27 7 45
Suicide prevention 8 23 5 36
Migrant Health 1 2 13 16
Sex workers 7 15 10 32
Radicalisation 7 12 7 26
Long term conditions 2 5 12 19
Dementia 9 20 9 38
Modern Slavery 6 20 6 32
Missing from home 7 21 6 34
Neglect 5 18 8 31
answered 38
5. From the list of pieces of work noted in Q5 above, please select ONE project that you feel best highlights good practice relevant to policing and health, and answer the following questions:
(State NA if not applicable):
Response
Total
1 Lead Agency: 27
2 Other Agencies/Partners involved: 26
3 Main aim: 27
4 Duration (or expected duration): 27
5 How was the work funded: 27
6 Was this a local / regional / national project? 27
7 How did you manage data/information sharing? 27
8 How did you measure impact / what outcome framework was used? 27
9 Any key lessons to be taken from this work? 26
answered 27
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6. Please give details of any pieces of work that your Force is / has been involved with that have cut across both policing and health (regardless of whether an official collaborative partner was involved)
Title:
Brief (to include aim of project
and key agencies involved):
Response Total
Work 1:
27
Work 2: etc…
26
answered 27
Organisational Priorities
7. What are the key priority areas for your Force currently that are relevant to policing and health? (please list what these priorities are, and include link if relevant)
Response
Total
1 Open-Ended Question 29
answered 29
8. Thinking about the list in Question 4 (or any other areas that are relevant), which aspects of policing and health are responsible for the greatest demand (volume and/or severity), or concern for your Force currently?
Response
Total
1 Open-Ended Question 25
answered 25
Governance, workforce development and information sharing
9. Is your Force currently involved / represented on any Health and Wellbeing Boards?
Response
Percent Response
Total
1 Yes
77.42% 24
2 No
12.90% 4
3 Not known
9.68% 3
answered 31
10. Focussing on workforce development, what initiatives / strategies are currently being adopted within your Force to encourage collaborative working, specifically within the areas of:
Response
Percent Response
Total
1 Leadership: 85.00% 17
2 Developing employee skill sets: 85.00% 17
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10. Focussing on workforce development, what initiatives / strategies are currently being adopted within your Force to encourage collaborative working, specifically within the areas of:
Response
Percent Response
Total
3 Recruitment: 45.00% 9
answered 20
11. Regarding information sharing between policing and health, what have been / what do your foresee as:
Response
Percent Response
Total
1 Enablers: 92.31% 24
2 Blockers: 92.31% 24
answered 26
12. What do you foresee as general enablers and blockers for collaborative working between policing and health?
Response
Percent Response
Total
1 Enablers: 92.59% 25
2 Blockers: 96.30% 26
answered 27
13. Do you have any further comments regarding best practice / gaps / future visions to help inform future collaborative working between policing and health?
Response
Total
1 Open-Ended Question 14
answered 14